Effectiveness of Peer-Supported Computer-Based CBT for Depression Among Veterans in Primary Care.
Effectiveness of Peer-Supported Computer-Based CBT for Depression Among Veterans in Primary Care.
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同伴支持的基于计算机的 CBT 对初级保健退伍军人抑郁症的有效性。
DOI：
10.1176/appi.ps.201900283
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Valenstein,Marcia
中科院分区：
文献类型：
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作者：
Pfeiffer,PaulN;Pope,Brooke;Houck,Marc;Benn-Burton,Wendy;Zivin,Kara;Ganoczy,Dara;Kim,HMyra;Walters,Heather;Emerson,Lauren;Nelson,CBeau;Abraham,KristenM;Valenstein,Marcia
目的：本研究检验在有抑郁生活经验的同伴专家的支持下，计算机化的抑郁症认知行为疗法（PS-cCBT）是否能改善初级保健患者的心理健康结局。方法在美国退伍军人事务部，新诊断为抑郁症的初级保健患者（N=330）被随机分配到3个月的PS-cCBT或常规护理对照组。使用线性混合效应模型来评估抑郁症状、一般心理健康状况、生活质量和心理健康恢复在基线和3个月和6个月时的差异。结果在调整分析中，接受PS-cCBT治疗的患者在抑郁症状自我报告快速量表上的抑郁症状改善程度在3个月时比对照组高1.4分（95%可信区间[CI]=0.3 ~ 2.5, p=0.01），但在6个月时无显著差异。PS-cCBT受者在生活质量享受与满意度问卷简表上的3个月生活质量改善也有2.6分（95% CI= 0.5-4.8, p=0.02），在康复评估量表上的3个月（3.6分，95% CI= 0.9-6.2, p=0.01）和6个月（4.5分，95% CI= 1.2-7.7, p=0.01）的康复改善也有较大的改善。结论sps - ccbt是改善初诊抑郁症患者短期抑郁症状和长期康复的有效选择。
ObjectiveThis study tested whether computerized cognitive-behavioral therapy for depression supported by a peer specialist with lived experience of depression (PS-cCBT) improves mental health–related outcomes for primary care patients.MethodsIn the U.S. Department of Veterans Affairs, primary care patients with a new diagnosis of depression (N=330) were randomly assigned to 3 months of PS-cCBT or a usual-care control condition. Linear mixed-effects models were used to assess differences in depression symptoms, general mental health status, quality of life, and mental health recovery measured at baseline and 3 and 6 months.ResultsIn adjusted analyses, participants who received PS-cCBT experienced 1.4 points’ (95% confidence interval [CI]=0.3–2.5, p=0.01) greater improvement in depression symptoms on the Quick Inventory of Depression Symptomatology–Self Report at 3 months, compared with the control group, but no significant difference was noted at 6 months. PS-cCBT recipients also had 2.6 points’ (95% CI=0.5–4.8, p=0.02) greater improvement in quality of life at 3 months on the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form and greater improvement in recovery on the Recovery Assessment Scale at 3 months (3.6 points; 95% CI=0.9–6.2, p=0.01) and 6 months (4.5 points; 95% CI=1.2–7.7, p=0.01).ConclusionsPS-cCBT is an effective option for improving short-term depression symptoms and longer-term recovery among primary care patients newly diagnosed as having depression.